THE LACRYMAL APPAKATUS 



287 



stained dark brown. The Streptothrix elements were no longer 

 visible ; still, the concretion had probably developed on such an 

 organic basis. 



When fully developed the clinical appearances are almost absolutely charac- 

 teristic. 1 The earliest records of this condition are by Cesoni (1670), Sandifors 

 (1779), and Desmarres (1842). Albrecht von Graefe was the first to give a clear 

 description (which still holds good) from ten cases under his own observation. He 

 stated definitely that the contents of the canaliculi must be of organic nature, 

 and this was confirmed by the microscope. Graefe was at first inclined to identify 

 the mould with favus. Conheim, on the other hand, defined it as ' Leptothrix.' 

 His views were followed by Leber and Waldeyer, the latter because the concretion 



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FIG. 57. CONCEEMENTS : DALEN'S CASE. 



in his case was dark brown, as is Leptothrix in the mouth. Both observers 

 make the reservation that the filaments which they found were here and there 

 branched, and also that they were different from Leptothrix in that the 

 characteristic iodine reaction was not obtained. Graefe then adopted the name 

 ' Leptothrix,' and the disease went under this designation until 1875. The same 

 explanation of the condition is repeated by Camuset and Hirschberg. Ferdinand 

 Cohn differentiates the mould from Leptotlirix for the reasons already given ; 

 he considered that he had to do with a special form, and gave it the name of 

 Streptothrix foersteri.- He stated that the filaments were of an even thickness 



1 Very exceptionally other foreign bodies are found (Mitvalsky). I have seen syphilis of 

 the canaliculus showing this appearance. 



2 Cazalis is quite wrong in applying this name to a variety of Streptothrix, growing on 

 agar as a thick dry mass, and which he obtained from the conjunctiva in trachoma, and 

 which I have also found under the same conditions. These are really examples of the 

 widespread Actinomyees albus (Lachner and Sandoval). 



